Painless
Painless is a fifth season episode of House which first aired on January 19, 2009. At Cameron's urging, House and the team take on the case of a man living with such severe chronic pain that he tries to kill himself, unable to go on after living for years without a diagnosis or any relief from his suffering. As they try to determine whether the man's pain is psychosomatic or caused by a physical disease, parallels between the patient and House's experiences with excruciating, prolonged pain become apparent. When the patient again attempts suicide under the team's care, their search for answers becomes urgent. Meanwhile, Foreman and Thirteen explore their now complicated relationship as they work together on the Huntington's disease clinical drug trial. Cuddy finds that taking care of her newly adopted baby leaves her little time to run a hospital and baby-sit House at the same time. House finds a leak in his water pipes. Recap A man tries to commit suicide by inhaling carbon monoxide, but his wife and son come home early and rescue him. He says he just couldn't take the pain any more. House is having pain problems of his own. While in the bathtub, he gasps in an effort to handle the increasing pain, then he moves his leg up out of the water and examines it. House meets Cuddy at the hospital entrance when he comes in - she is usually there much earlier and he guesses her new baby made her late, but it was her administrative duties instead. House apologizes for not doing his budget, but Cuddy says Cameron did it for him so she would be owed a favor. Cameron comes to him with patient - he's in chronic pain with no seeming cause. House thinks it is drug seeking behavior, but Cameron points out the patient had narcotics and didn't even use them to try to commit suicide. Cameron dismisses Thirteen's diagnosis of fibromyalgia and Taub's guess that it is mental illness. None of the patient's previous doctors have found anything wrong with him. House orders a pain assessment to rule out anything psychosomatic, and an environmental scan. Taub does the assessment. The responses of the patient, wife and son are consistent. Foreman does the environmental scan with Thirteen and find more drugs than House uses. Foreman thinks Thirteen is avoiding him after they kissed. Thirteen makes it clear she doesn't want to drag down Foreman. They find quail and Thirteen thinks it is food poisoning but Taub thinks the profile shows the pain is psychosomatic. House thinks it is rhabdomyolysis from food poisoning and orders a biopsy of the patient's muscles. While Thirteen and Kutner work on it, the patient has great pain in his right arm and goes into cardiac arrest. The team calls House at home, but he doesn't answer. He calls back and guesses they must be calling about a pulmonary embolism. It shows the pain isn't psychosomatic, but it isn't rhabdomyolysis either. House orders them to scan for tumors. He then notices his ceiling is leaking. He dries it with a towel on his cane, but when he pokes it with his cane the ceiling collapses and dumps water on him. Taub and Kutner do the scan and discuss suicide and their childhoods. Kutner finds something near the diaphragm. House has a workman come in. The workman says the leak is the result of negligence from pulling on the pipe and isn't covered by insurance. It will cost $2,200 to fix. Foreman once again tries to talk Thirteen into having a relationship. She points out how unhappy the patient's family is. Kutner and Taub come in with the results which show that there is air near the patient's intestines. Kutner and Thirteen decide to do an angioplasty to find the blockages. House comes in to find his team believing they have solved the problem. However, House realizes the patient tried to inject air into a blood vessel to kill himself - the air they found wasn't a symptom. The patient admits he tried to kill himself again. They put the patient in a hyperbaric chamber to work the air out of his system. Cuddy calls the team over to her house to punish them for letting the patient attempt suicide. Thirteen wants to focus on the abdominal pain, which was the first symptom. Foreman thinks it is a glycogen storage disease. House agrees and orders the test. Cuddy gives Kutner Rachel’s diapers to dispose of. Thirteen runs into Janice, who is showing improvement. She finds Janice's appointment was moved to be next to her. Taub and Kutner put the patient through tests. He sends his family out of the room because they are causing him stress. Suddenly, the pain shoots through the patient’s leg and he drops the tennis ball he was squeezing. Thirteen confronts Foreman about Janice's appointment, but he didn't know her appointment had been changed, or that she had improved. He denies setting her up. House asks Taub for the name of a lawyer. House decides he has to inject lidocaine just below the patient’s brain stem to separate the patient's brain from his body and figure where the pain is originating. Cuddy refuses due to the risks, but House points out the patient is suicidal. She finally agrees. Chase starts to anesthetize the patient and House shows up. House is having a lot of pain too. They discuss their levels of pain. The patient says House can handle it because he doesn't have to hide it from a family. Cuddy is dealing with the foster care agency. The place is a mess because her maid is late, and House dumped Rachel‘s diaper in her purse. However, the agency man is impressed anyway. He tells her she's way above most foster moms. The patient loses most of his pain under anesthetic, but not all of it. A lawyer comes in with a bill for House sending out a threatening e-mail about the insurance problem under his name. He promises a lawsuit if House does it again. Suddenly, the patient's son falls on the floor in tremendous pain. House thinks he is faking. He finds the patient tried to commit suicide by drinking rubbing alcohol. House orders dialysis. The son distracted everyone so the patient could try suicide again. The son asks the doctors to let his father die. The team runs out of ideas. Foreman agrees something must explain the pain, but House says what if it's nothing. He thinks it might be opioid induced pain. He orders the drugs discontinued. The team resists, but House tells them to do it anyway. Wilson arrives at Cuddy's home with a big stuffed toy duck for Cuddy. She tells him he passed the inspection. She's worried about trying to supervise House while trying to take care of the baby. Wilson tells her her standards are too high and tells her to get more help both at work and at home. They inject the patient with naloxone, a drug that blocks opiates. The patient pleads with them not to. Kutner presses Taub and Taub admits that one of the residents he knew tried to commit suicide, but it was a bigger burden on their families. He thinks the suicide attempt was selfish. House finds out that Foreman actually did move Janice's appointment. House burns part of his kitchen to get his insurance to pay for the pipes above it, quoting verbatim from the insurance policy. However, the pipes above his kitchen aren't his. The patient doesn't get better, so they put him back on pain medication. The wife confronts House about not having an answer. She thought House would understand because of his own pain. She wants her husband discharged. House agrees to discharge the patient. House bribes the handyman to lie to the insurance company about his broken pipes. However, the bribe was bigger than the costs of the repair. As House sees the handyman pack up, scratching at his crotch as he does so, he gets an idea. House goes to the team and asks about testicles. He talks about epilepsy and how it might affect the muscles affecting the testicles. Because the control of those muscles are deep in the brain, a seizure wouldn't show up on an EEG or show neurological symptoms. He confronts the patient - the pain didn't start in the stomach, but lower down. If it did - it's treatable. They start treating the patient for epilepsy and he slowly improves. Kutner asks if Taub if he was the one who attempted suicide. Taub denies it. Thirteen shows up early for her appointment. She asks Foreman out. He goes to speak to a nurse about doing the IV wrong, and she lets it slip Thirteen is on the placebo. Cuddy goes to Cameron to offer her a temporary administrative position. House goes to take a bath and realizes he’s been pulling on the pipes to help himself in and out of the bath and realizes he actually did cause the damage to his own pipes. Zebra Factor 10/10 Epilepsy is not a rare disorder. It occurs in about one out of every 120 people. However, there have only ever been around 36 recorded cases of Abdominal Epilepsy. Major Events * Cuddy reveals that her adopted daughter's name is Rachel. * House drops hints of Foreman and Thirteen being together. * Cuddy struggles to cope with running the hospital as well as looking after her new baby. * Foreman learns that Thirteen may be on a placebo for her Huntington's clinical trials. * Cuddy asks Cameron to become temporary deputy administrator. * House finds out the leaky pipe is caused by when he supports himself in the shower's pipe to enter the bathtub, shaking the entire plumbing connected to it. Trivia and Cultural References *House's use of the term "the milk of human kindness" may be a reference to Shakespeare's "Macbeth". *Mowgli is the "man-cub" and main protagonist in "The Jungle Book" and its sequel. *Christian Science is a Protestant religious denomination that was founded in the United States in the 19th century. Although they are not prohibited from seeking medical treatment (and usually do so in cases of physical injury), in most cases of illness they prefer prayer as a first resort. *Fire Island is a barrier island and seasonal vacation area off the south shore of Long Island, New York. Since the 1960s, it has been closely associated with Gay culture. *The suicide note shown in the beginning isn't entirely readable, but certain parts can be made out: **"... what I do may God forgive me... ... I love you both but I have no... ... any more unhappiness... ...Zach. I hope that someday he... *12 tribes is a reference to the twelve Israelite tribes. *A shyster is a deceptive lawyer or fraud. *When the lawyer comes and asks for House, House identifies Foreman as himself. When the lawyer leaves, House says to Foreman: "Can you blame me? The last time that happened the guy shot me." This is a reference to the season 2 finale, No Reason. *"Painless" The title of the episode is a reference to the theme song of the Show M*A*S*H "Suicide is Painless". Cast *Hugh Laurie as Gregory House *Lisa Edelstein as Lisa Cuddy *Omar Epps as Eric Foreman *Robert Sean Leonard as James Wilson *Jennifer Morrison as Allison Cameron *Jesse Spencer as Robert Chase *Peter Jacobson as Chris Taub *Kal Penn as Lawrence Kutner *Olivia Wilde as Remy Hadley *Martin Henderson as Jeff *Jake Cherry as Zach *Sarah Danielle Goldberg as Lynne *Alex Fernandez as Fernando *Anthony Montgomery as James Carlton *Lori Petty as Janice Burke *James Ingersoll as Chris Carrick *Aisha Kabia as Nurse Rita *Bobbin Bergstrom as Nurse Links *Episode page at IMDB *Episode article at Wikipedia *Episode page at House MD Guide *Episode transcript at Clinic Duty *Episode review at Blogcritics *Episode page at TV.com *Episode article at The TV IV *Mirror article at the Vietnamese House Wiki *A review of the medicine at Polite Dissent Category:Episodes Category:Season 5 Category:Zebra Factor 10